Diabetes: What is your A1C telling you?

The Diagnosis: Your doctor just gave you the diagnosis ”I’m sorry, you have diabetes. Your A1C is high, it is 9, should be under 6.5. You need to do something about it, I may have to put you on medication.” Your head is still swirling around that diagnosis, Diabetes with a big “D”.
What does high A1C mean? What’s so different between 6.5 (nondiabetic) and 9, it is only a difference of 2.5. Doesn’t seem so bad. You’re looking at a number which just an indicator of what’s going on in your body, not just with glucose metabolism, but metabolism as a whole.

Glucose the Energy fuel: Glucose, of course, is our energy fuel, it is very important. We use it for making energy, building up cells, tissues, repairing ourselves. Our muscles need its energy to work. Glucose needs to be inside the cell.

Insulin resistance: Insulin will take the glucose inside the muscle cell with its receptor. it’s like the doorman opening the door, for you. When the glucose is high, your pancreas, puts out a lot of insulin. At first, muscles are happy to open the doors and letting the glucose in. and extra is stored as glycogen. However, they only have limited capacity to store. Once you have enough in the muscle, muscle shuts the door, switches off or removes the insulin receptor. No matter how much insulin is there, insulin cannot get glucose into the cells. Insulin resistance develops.

Excess glucose, the troublemaker: Excess glucose in the blood waiting to be converted to storage, is a troublemaker. It starts combining with different proteins in your body such as hemoglobin, your A1C (HbA1C). That number tells you how much of hemoglobin, which is your oxygen carrying molecule in your RBC, is coupled with glucose.

Glucose and proteins a deadly marriage: It takes a lot of glucose to make those numbers change. That’s why that little difference of 2.5 from 6.5 to 9 means you had a lot of excess glucose in your blood. For rough estimate just multiply A1C by approximately 20. For 6.5A1C, your fasting glucose level, is about 130. Not perfect, but not terrible. When A1C is 9 it is180. You can do something about it. All the lifestyle choices matter. A1C is trying to get your attention.